The New York Node of the CTN is a consortium of academic centers, clinical programs and local and regional agencies with a long track record of fruitful collaboration in research, training, service delivery, policy-making, funding and advocacy for the addictive disorders. The consortium offers a rich array of human talent and has access to vast clinical and policy resources in NY City, NY State and regionally. Together, these investigators, providers and policy-makers have extensive large-scale clinical trials expertise, a broad range of research interests, unique treatment capacity and extensive services and policy experience. Over the past five years the NY Node has built effective internal and external working relationships, it has contributed to the national CTN infrastructure, it has built a solid and flexible local infrastructure and it has effectively implemented protocols as a Lead Node and as a Participating Node. The NY Node played a key role in organizing NIDA's NY Blending Conference in March, 2002, and has successfully worked with emerging local coalitions to foster dissemination and adoption of CTN innovations. NY Node providers and researchers are involved in planning and developing three studies (START, ADHD and prescription opiate analgesic dependence protocols) that will be of high priority for NIDA over the next few years and our CTPs are all well positioned to test and introduce medical interventions. The present proposal is contextualized by five years of CTN experience and by our assessment of the accomplishments of, and challenges facing, the CTN. Our overall thematic approach capitalizes on CTN and Node accomplishments to-date and addresses challenges for the future. We bring in new investigators and expertise, we describe an enhanced science-to-practice model for CTN studies, we expand relationships with state and local government agencies to enable this, and we propose a research concept that works within this framework. Themes include reaching out to primary-care providers, extending relevant outcomes, partnering with agencies that can share study costs and foster adoption, and addressing systems of reimbursement and organization of care. Our research concept builds on these themes to extend the reach of the CTN and to enhance the likelihood that CTN studies will have impact and lead to improved healthcare on a broader level.